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HomeMy WebLinkAboutPermit Electrical 1993-5-28 225 FIFTH STREET ,. ",wal. SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769Ino OFFICE: 726-3759 D~9 rl~Lts 1. LOCATION OF INSTAt~TIQNSlgnature ~?3/ .tliJ4-:11 / ,,-r p'-/tJ/ c...c.... ~: (J A. LEGAL DESCRIPTION /7-d":l-"3/'t.//, b"--:-e. ,,!gB DESCRIPTION . hJ~TJ9-/1 L"l.eC-Ab/'/r-1 Jy.f"I-en-L Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor (;/Jru;T;'.,I;J! Address PO~ 1/ t9/Jq Ci ty &,,~/'~ / Phone 1./ff:-r:~/7!c,/ Supervisor License Number .5"7 "ecr Expiration Date /t:1- 30-- 9~ City Job Number ~~~'CL-- COMPLETE FEE SCHEDULE BELOII q 3CJ.oB New Residential-Single or Multi-Family per dwelling Service Included: Items 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder B. Services or Feeders Installation, Alterations Relocation: 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only unit . Cost Sum $ 85.00 $ 15.00 $ 40.00 or * '" $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Constr Contr. Number ~-/~7 cLE= Installation, Alteration or Relocation . Signature of Supervising Electrician /~~~ . ^f\rJI i\f\nA\/"Onl ) D. BranchCircuits Owners Name ~.~;U I ~ \ 1\ . I ~ l YJ'I .IL../ Address 401 r\. -royy\.nh(Ut}l~'S ~ Alteration or Extension Per Panel ~\~A.-- . One Circui t $ 35.00 City VI lYl _ Phone Each Additional . L,n~'l\-l Circuit or with Service 01lNER INSTALLATio'N' or Feeder Permit Expiration Date 9-1}3 The 'installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: DATE: 1U:.\..t.1PT II: RECEIVED BY: >-:<e'"T~ f/!f6~ "'3 ~< ~-- '/ 200 amps 201 amps Over 401 Over 600 or less to 400 amps to 600 amps amps or 1000 volts $ 40.00 $ 55.00 $ 80.00 see "B", above $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res $ 20.00 Limi ted Energy/Comm I $ 36.00 3~,m 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL 3~,&o / , ,r'O <, ") . R-O